TNCC Abdominal Trauma 3

Question 1

A patient with splenic laceration is being managed non-operatively. Which vital sign trend is the most critical indicator requiring reassessment for operative intervention?

Accepted Answer

Persistent tachycardia above 100 bpm despite 2L crystalloid

Answer

Persistent tachycardia despite adequate fluid resuscitation indicates ongoing hemorrhage and failure of non-operative management, requiring surgical intervention.

Question 2

In the TNCC framework, which finding on abdominal inspection is considered a high-priority finding suggesting serious intra-abdominal injury?

Accepted Answer

Mild periumbilical ecchymosis appearing 6 hours post-injury

Answer

Cullen's sign (periumbilical ecchymosis) indicates retroperitoneal hemorrhage tracking to the umbilicus, suggesting significant intra-abdominal injury; its presence within hours is a serious finding.

Question 3

When performing the abdominal assessment in the TNCC primary survey, auscultation is performed before palpation because:

Accepted Answer

Palpation may stimulate bowel sounds and falsely alter auscultation findings

Answer

Palpation can artificially stimulate or suppress bowel sounds, so auscultation must precede palpation to obtain accurate bowel sound assessment.

Question 4

A patient with abdominal trauma has Grey Turner's sign. This finding is associated with:

Accepted Answer

Retroperitoneal hemorrhage tracking to the flank

Answer

Grey Turner's sign is flank ecchymosis caused by retroperitoneal blood dissecting through fascial planes to the flank region.

Question 5

Which of the following is the most appropriate fluid resuscitation strategy for a hemodynamically unstable patient with suspected massive intra-abdominal hemorrhage?

Accepted Answer

Permissive hypotension with damage control resuscitation using blood products

Answer

Damage control resuscitation with permissive hypotension (target SBP 80–90 mmHg) and balanced blood product transfusion prevents dilutional coagulopathy and reduces ongoing hemorrhage.

(TNCC) Trauma Nursing Core Course Certified Practice Test

(TNCC) Trauma Nursing Core Course Certified Practice Test

TNCC Abdominal Trauma 3